Dr. Wikipedia?

Reading about Wikipedia’s success via peer production and “free failure” this week got me thinking, “How has Wikipedia – and social media, with its open-access to information – impacted health?”   lucy-psychiatrist Well, it’s made a huge impact. Online resources have become a persistent player in health care. According to the Pew Internet’s Health Online 2013 report, 35% of U.S. adults have consulted online resources to match symptoms with a medical diagnosis. Almost 60% of adults have looked online for health information, and over a third are “online diagnosers.” However, only half of these “online diagnosers” followed up with a clinician regarding what they found online; 38% felt that their “condition” could be taken care of at home. And, 77% of online health seekers started their search at a search engine, such as Google, Bing, or Yahoo, followed by 13% who started at a site that specialized in health information, like WebMD.   Perhaps not surprisingly, Wikipedia is now the leading single source of health care information for both patients and clinicians. In fact, according to IMS Institute for Healthcare Informatic’s January 2014 report, Engaging Patients Through Social Media, as many as 50% of physicians in the U.S. who go online use Wikipedia to get information. wikipedia logo

Wikipedia’s reach

Wikipedia has been around since January 15, 2001. It is openly editable and collaboratively written over the Internet by unpaid volunteers. As of this month, it has 32.4 million freely usable articles in 287 languages, written by over 47 million users across the world. It is the sixth most popular website, after Google, Facebook, YouTube, Yahoo!, and Baidu. It is the only reference website amongst the top 100 most popular sites, and the top external site visited after Google according to the PewInternet.

Regarding health, what do people search for on Wikipedia?

The IMS report states that the top 5 conditions searched for are Crohn’s disease, tuberculosis, pneumonia, multiple sclerosis, and diabetes.

Screenshot 2014-07-27 18.03.42

Courtesy IMS Institute’s Engaging Patients Through Social Media, Jan 2014

In general, people use Wikipedia to read about rare diseases rather than common conditions. Patients specifically use it as a starting point for self-education. And, patients 38 and younger are more likely to read information on treatments prior to beginning treatment, while those over 54 are more likely to search after starting treatment.

So should I be getting information from Wikipedia?

While not a .gov or .edu, the public perceives Wikipedia as a credible source of information. Matt and Amanda have already written great posts about determining if health info online is trustworthy, or total hooey. Use Wikipedia at your own risk: it is crowd-sourced information which is not necessarily accurate or neutral. Other critiques include that it is subject to vandalism, written by bots, and has limited editor diversity (mostly white males from Western countries). Screenshot 2014-07-27 18.28.25 white male art historial i edit wikipediaVietnam I edit wikipediabreast cancer i edit wikipdia

Use Wikipedia at your own discretion, but it’s here to stay.

As a health care provider I recognize that many of my patients and students will turn to Wikipedia. So, I aim address misinformation directly, in person, as the articles often contain many errors. Taking active parts in correcting these errors is also helpful, such as WikiProject Medicine, which includes a UCSF School of Medicine 4th-year, one-month elective course aimed explicitly at improving medical topic coverage.

 

For more information on online medical professionalism, check out this policy statement from the American College of Physicians and the Federation of the State Medical BoardsGreysen SR, Johnson D, Kind T, Chretien KC, Gross CP, Young A, et al. Online Professionalism Investigations by State Medical Boards: First, Do No Harm. Ann Intern Med. 2013;158:124-130.

What online resources do you rely on for health information?

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11 thoughts on “Dr. Wikipedia?

  1. Debora,
    This is such a great topic and I glad you brought it up. I see this phenomenon of “googling” symptoms quite a bit at work, and my response to patients is, “oh and when did you go to medical school”… This reminds me of a very funny episode of the Big Bang Theory, where Sheldon diagnosis his gas pain this the craziest disease he could find on the internet. Although this is based in comedy, it is very real life to how patients can mis-use internet, and to boot, get the wrong information from online sources. I’m surprised the statistic is only 35% for those to match symptoms, I would have guessed to to be higher that than.

    • Hi Kirstie, I was surprised at the statistic also; 35% feels low, in my opinion. It does make me wonder if there is any bias and the value is an underestimation. And that Big Bang Theory episode is spot-on!

  2. Debora,
    This is a great post. I would be interested to hear from you, and also from the other physicians in his group, as to whether you feel the increased access to healthcare information and detailed symptoms is a good or bad thing in general. I can see that its use for self-education is vital, but has it made communication in the doctor’s office harder or easier? I know I always feel a little ashamed to admit “I read it on-line” when I am talking to my physician and often feel that the phrase automatically nullifies the validly of what I am about to say!

    • Thanks Rachel! I can only speak for myself; I’ve felt that the ease of googling symptoms hasn’t changed my job much as it can open up discussion. But occasionally it has made my job harder. For example, I had one woman who had googled her symptoms of “headache” and “blurry vision one eye” and was convinced that these were due to multiple sclerosis (MS). She just needed me to confirm the diagnosis. (I’m an optometrist, I do not diagnose MS.) Anyway, it took me a while to convince her that her symptoms were due to an improper glasses prescription, not MS. Of course, her story is quite the extreme. But, it illustrated to me that some patients have difficulty describing their own symptoms, that online info may only depict the “worst case” or “rare case” scenario, and that patients could use help wading through all the info available on the internet.

  3. Personally, I have never minded the patients who come in with an “internet diagnosis”. Sometimes they are right, sometimes not. But at least they are open to a discussion. The ones that concern me are those who DON’T come in. Do they assume their diagnosis is correct and begin or decline treatment based on that assumption?

    • I agree, Randal. My clients that come in having already looked stuff up on the internet are sometimes easier to discuss things with because they already understand a little of what might be going on and they are usually fairly open to my advice. But the clients that look stuff up on the internet and therefore decide they don’t need to come in – those are the ones really putting their pets (and themselves if they do the same thing with their health) in danger. Great post.

  4. I loved this post. My neighbor was complaining that his doctor sat down with him and googled a condition that my neighbor thought might be the problem. This alarmed my neighbor that his physician would use the same source for diagnosis that he would.

  5. Randall, great article! I use to use Wikipedia quite a bit. However, in the last year I have cooled off on using it for many of the reasons that you stated. I prefer to use website with .gov or website where I know professionals are giving the information. Personally, when it comes to health related information I like to use PubMed as they only deal with peer reviewed literature.

  6. Deborah,
    I agree that looking up diseases online can sometimes make the situation worse. There is a hypochrondriac in my house, she searches everything on the internet and then start using all the bizzare home remedies.

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